Editorial: Between fires, earthquakes and pandemic, supporting Measure F is a no-brainer

Let’s talk numbers. Of the 10,000 people who visit the emergency department at Sonoma Valley Hospital each year, roughly 75% have government-based insurance plans like Medicare or Medi-Cal. On average, those plans only cover 86% of the cost of service, leaving the hospital to find a way to cover the 14% gap to keep their bottom line intact. At Sonoma Valley Hospital, that gap represented $9.8 million in 2019.

What is a small hospital to do?

It’s a reality that is killing community hospitals all across the country, as the cost to provide services continually climbs faster than the reimbursement rates from Uncle Sam and Auntie California. According to NPR, “The National Rural Health Association says 673 rural hospitals are at risk to close, and 210 of those are at ‘extreme risk’ — 60 rural hospitals closed between 2010 and February 2016.”

We’ve seen small hospitals hit the brink here in Sonoma County. After decades of local ownership, citizens in both west county and Petaluma recently voted to sell their community hospitals to private health care groups with bigger resources, which are better equipped to keep the doors open thanks to the purchasing and negotiating power of a larger operation.

Despite the bleak financial realities, Sonoma Valley Hospital consistently punches above its weight class when it comes to local health care. It sits in the top 25% of all hospitals in the country in quality, according to the Centers for Medicare and Medicaid Services. Its partnership with UCSF means that some of the best physicians in the Bay Area are treating patients right here in town, a relationship that continues to grow. Three of the hospital’s top executives, including CEO John Hennelly, are employed by UCSF (the local hospital reimburses the famed medical school for their salaries). It ensures a close-knit connection that will continue to bring new services and top-notch doctors to practice at Sonoma Valley Hospital.

All these efforts will improve the bottom line of our hospital, which makes the bulk of its patient revenue performing more lucrative procedures for private-insurance patients, like a knee replacement. But in the pandemic, nonemergency procedures were cut back severely to limit potential COVID-19 exposure, leaving many medical facilities in a lurch, even as government support increased.

On the razor’s edge of health care financing, the margins are so thin, even the hospital’s innovative efforts to generate new revenue fall short, leaving a $6.5 million deficit. Sonoma Valley Hospital has consistently drawn support from our Valley’s deepest pockets, who have spent millions in capital campaigns to fund hospital operations. But when the hospital needed extensive seismic improvements, it turned to the voters.

In 2002, facing a loss of $20 million, the hospital successfully secured its first $130 parcel tax for five years. Every five years it came back to the ballot, growing to $195 in 2007 and 2012, but always earning the extra-high bar of 66.7% of the vote. After a near miss in March, 2017, when the measure failed by just 64 votes, it came back to the ballot at $250 a few months later, earning 69% approval from the electorate.

The voting record is clear — the people of Sonoma want a hospital. And they know they have to pay to keep it open, so that no one has to drive 30+ minutes for major medical assistance.

Measure F seeks to extend the $250 parcel tax for 10 years this time, bringing in roughly $4 million annually for the cash-strapped hospital. Considering the rising cost of inflation, not to mention our heightened cost of living and the national nursing shortage, the hospital probably should have asked for even more from property owners to get through the next decade. But leaders chose to be conservative, hopeful that the partnership with UCSF will continue to blossom and enhance patient revenue.

Considering the many traumas of recent years — fires, earthquakes and pandemics — and the geographically isolated nature of Sonoma Valley, which could be easily cut off from access to hospitals in Santa Rosa, Petaluma or Napa, the parcel tax is a no-brainer. And a small price to pay for the peace of mind that a loved one will make it a hospital in time after a stroke or heart attack.

For the health of us all, vote yes on Measure F.